Your upper canine teeth are pretty easy to identify — they’re usually longer and more pointed than other front teeth, and are normally positioned just under the eyes (hence their other name, eyeteeth). Besides helping us chew and bite our food, upper canines are part of a normal smile — when they don’t appear in the mouth (erupt) properly, the person’s smile may appear unnatural or “off.”

Unfortunately, upper canines can become impacted, meaning the teeth have grown and developed in positions that prevent them from erupting. Because impacted teeth can develop abscesses and cysts, or damage the roots of neighboring teeth, it’s necessary to treat them.

The first step is a thorough orthodontic evaluation to assess not only the teeth in question, but also how they could affect the position of other teeth in the future. Next, we must locate the exact position of the impacted canines through some form of radiographic examination, either x-rays or 3-D imaging using a cone beam CT scanner (CBCT). This evaluation will determine our treatment options for these teeth.

If the teeth are in a reasonable position, the best option is to expose the impacted tooth and prepare it for movement into proper position. To expose the tooth, a surgeon creates a small, surgical opening or flap in the gum tissue closest to the crown of the tooth. Once gaining access, the surgeon then bonds a small bracket to the crown and attaches a small gold chain to it. The chain can then be looped over orthodontic hardware attached to adjacent teeth, which will pull the impacted tooth over time into the proper position. Although this may sound complicated, coaxing the impacted canine in this manner into a proper eruption is actually quite routine and predictable.

If at all possible, saving impacted upper canine teeth should be the primary treatment goal — extracting them could have an adverse effect on biting and chewing, as well as disrupting your appearance. If they must be removed, however, tooth replacement such as dental implants can help restore any lost form or function.